Risk factor associated with protracted anaphylaxis in pediatric patients, Chiangrai prachanukroh regional hospital
Keywords:
Anaphylaxis, Protracted anaphylaxis, Adrenaline, AllergenAbstract
Background: Protracted anaphylaxis is an allergic reaction that lasts hours to days without
completely resolution of symptoms. There are less studies about factors associated with
protracted anaphylaxis
Objective: To find the associated risk factors of protracted anaphylaxis, incidence, allergen
exposure, clinical manifestation of protracted anaphylaxis
Methods: This retrospective cohort study included pediatric patients diagnosed with
anaphylaxis, aged 0-15 years, in Chiangrai Prachanukroh regional hospital, during Aug
2014 to July 2020. Patients’ medical history and treatment were collected from electronic
medical record
Results: Among 135 anaphylactic patients, rate of protracted anaphylaxis is 14.81%. Median
age is 9 years old and most patients are male (54.07%). Risk factors associated with protracted
anaphylaxis is time to adrenaline from the symptom onset more than 90 minutes (OR 5.76,
95%CI 1.05-31.51, p-value 0.043). Most common allergen exposures are food (50.37%),
unknown allergen (28.15%) and insects bite (16.30%). Most patients present with itchy
(78.52%), urticaria (71.85%) and dyspnea (55.56%).
Conclusion: Pediatric patient who was diagnosed with anaphylaxis take risk to develop
protracted anaphylaxis if delay adrenaline injection over 90 minutes. The incidence of
protracted anaphylaxis was found 14.81% and important allergen was food especially shrimp.
Clinical manifestation was described as previous studies.
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คณะทำงานเพื่อการรักษาและป้องกันการแพ้ชนิดรุนแรงแห่งประเทศไทย. แนวทางเวชปฏิบัติสำหรับการดูแลผู้ป่วยที่มีการแพ้ชนิดรุนแรง พ.ศ. 2560
Piromrat K,Chinratanapisit S, Trathong S. Anaphylaxis in an emergency department: a 2-year study in a tertiary-care hospital. Asian Pac J Allergy Immunol. 2008;26(2-3):121-8
Manuyakorn W, Benjaponpitak S, Kamchaisatian W, Vilaiyuk S, Sasisakulporn C, Jotikasthira W. Pediatric anaphylaxis: triggers, clinical features, and treatment in a tertiary-care hospital. Asian Pac J Allergy Immunol. 2015;33:281-8
Sricharoen P, Sittichanbuncha Y, Wibulpolprasert A, Srabongkosh E, Sawanyawisuth K. What clinical factors are associated with biphasic anaphylaxis in Thai adult patients? Asian Pac J Allergy Immunol. 2015;33:8-13
Shaker MS, Wallace DV, Golden DBK, et al. Anaphylaxis-a 2020 practice parameter update, systematic review, and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis. J Allergy Clin Immunol. 2020;145:1082-123.
Lertnawapan R, Maek-a-nantawat W. Anaphylaxis and biphasic phase in Thailand: 4-year observation. Allergol Int. 2011;60:283-9
Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report - Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium. Ann Emerg Med 2006; 47:373-80.
Ring J, Klimek L, Worm M. Adrenaline in the Acute Treatment of Anaphylaxis. Dtsch Arztebl Int. 2018;115(31-32):528-34.
Alqurashi W, Stiell I, Chan K, Neto G, Alsadoon A, Wells G. Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis. Ann Allergy Asthma Immunol. 2015;115:217-23 e2.
Lee S, Peterson A, Lohse CM, Hess EP, Campbell RL. Further Evaluation of Factors That May Predict Biphasic Reactions in Emergency Department Anaphylaxis Patients. J Allergy Clin Immunol Pract. 2017:1295-1301.
Lertnawapan R, Maek-a-nantawat W. Anaphylaxis and biphasic phase in Thailand: 4-year observation. Allergol Int. 2011;60: 283-9.
Ko BS, Kim WY, Ryoo SM, et al. Biphasic reactions in patients with anaphylaxis treated with corticosteroids. Ann Allergy Asthma Immunol. 2015;115:312-6.
Poachanukoon O, Paopairochanakorn C. Incidence of anaphylaxis in the emergency department: a 1-year study in a university hospital. Asian Pac J Allergy Immunol. 2006;24(2-3):111-6.
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